Olbrzymi tętniak obejmujący kilka tętnic wieńcowych, w tym pień tętnicy wieńcowej lewej, powodujący objawy ostrego zespołu wieńcowego u 23-letniego chorego: nietypowe powikłanie choroby Kawasaki
Streszczenie
The reported incidence of coronary artery aneurysms (CAA) on angiography varies between 0.3 to 5.3%. Right coronary artery is the most commonly affected followed by left circumflex or left anterior descending artery. Three-vessel or left main involvement is exceedingly rare. Atherosclerosis accounts for the vast majority of CAAs in adults, whereas Kawasaki disease is responsible for most cases in children. We report a rare case of Kawasaki disease associated with giant aneurysms ( > 8 mm) in coronary circulation, including left main coronary artery in 23-year-old male having maturity onset diabetes (MODY), who presented with acute coronary syndrome.
Słowa kluczowe: tętniak tętnic wieńcowychchoroba Kawasakiolbrzymi tętniak
Referencje
- Kato H, Koike S, Yamamoto M, et al. Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr. 1975; 86(6): 892–898.
- Newburger JW, Takahashi M, Burns J, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med. 1986; 315(6): 341–347.
- Kato H, Ichinose E, Yoshioka F, et al. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study. Am J Cardiol. 1982; 49(7): 1758–1766.
- Robertson T, Fisher L. Prognostic significance of coronary artery aneurysm and ectasia in the Coronary Artery Surgery Study (CASS) registry. In: Schulman ST. ed. Kawasaki disease: progress in clinical and biological research. Vol. 2. Alan R. Liss., New York 1987: 325–339.
- Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation. 1996; 94(6): 1379–1385.
- Suda K, Iemura M, Nishiono H, et al. Long-term prognosis of patients with Kawasaki disease complicated by giant coronary aneurysms: a single-institution experience. Circulation. 2011; 123(17): 1836–1842.
- Mitani Y, Sawada H, Hayakawa H, et al. Elevated levels of high-sensitivity C-reactive protein and serum amyloid-A late after Kawasaki disease: association between inflammation and late coronary sequelae in Kawasaki disease. Circulation. 2005; 111(1): 38–43.
- Cheung Yf, O K, Woo CWH, et al. Oxidative stress in children late after Kawasaki disease: relationship with carotid atherosclerosis and stiffness. BMC Pediatr. 2008; 8: 20.
- Kato H, Inoue O O, Kawasaki T. Adult coronary artery disease probably due to childhood Kawasaki disease. Lancet. 1992; 340(8828): 1127–1129.